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2016 ; 48
(6
): 461-6
Nephropedia Template TP
Iqbal J
; Dufendach KR
; Wellons JC
; Kuba MG
; Nickols HH
; Gómez-Duarte OG
; Wynn JL
Infect Dis (Lond)
2016[]; 48
(6
): 461-6
PMID27030919
show ga
Neonatal meningitis is a rare but devastating condition. Multi-drug resistant
(MDR) bacteria represent a substantial global health risk. This study reports on
an aggressive case of lethal neonatal meningitis due to a MDR Escherichia coli
(serotype O75:H5:K1). Serotyping, MDR pattern and phylogenetic typing revealed
that this strain is an emergent and highly virulent neonatal meningitis E. coli
isolate. The isolate was resistant to both ampicillin and gentamicin; antibiotics
currently used for empiric neonatal sepsis treatment. The strain was also
positive for multiple virulence genes including K1 capsule, fimbrial adhesion
fimH, siderophore receptors iroN, fyuA and iutA, secreted autotransporter toxin
sat, membrane associated proteases ompA and ompT, type II polysaccharide
synthesis genes (kpsMTII) and pathogenicity-associated island (PAI)-associated
malX gene. The presence of highly-virulent MDR organisms isolated in neonates
underscores the need to implement rapid drug resistance diagnostic methods and
should prompt consideration of alternate empiric therapy in neonates with Gram
negative meningitis.